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压迫疗法治疗静脉溃疡的成本效益分析。

Cost-effectiveness analysis of the treatment with compressive therapy in the healing of venous ulcers.

机构信息

Hospital Universitário Graffre Guinle, Centro de Terapia Intensiva, Rio de Janeiro, RJ, Brasil.

Hospital Central da Aeronáutica, Rio de Janeiro, RJ, Brasil.

出版信息

Rev Lat Am Enfermagem. 2023 Mar 27;31:e3839. doi: 10.1590/1518-8345.6017-3839.

Abstract

OBJECTIVE

to analyze the cost-effectiveness and calculate the incremental cost-effectiveness ratio of multilayer compressive treatment in relation to inelastic (Unna boot and short stretch) therapy according to the current literature.

METHOD

quantitative study about cost-effectiveness through modeling with the aid of TreeAge® software for construction of the decision tree. The anticipated assumptions were obtained by using secondary literature data to estimate the cost and effectiveness of the assumed parameters. A systematic literature review with meta-analysis was performed for this end.

RESULTS

the decision tree after Roll Back showed that the multilayer therapy dominated the alternatives in the base case, representing an intermediate cost per application, although with the highest effectiveness. The cost-effectiveness analysis graph also showed extended dominance of the Unna boot in relation to the short stretch bandage. The sensitivity analysis showed that multilayer bandage remains a more cost-effective alternative, within the threshold of willingness to pay.

CONCLUSION

the most cost-effective alternative was multilayer bandage, considered the gold standard in the literature. The second most cost-effective alternative was the Unna boot, the most used therapy in Brazil.

摘要

目的

根据现有文献,分析多层压缩治疗相对于非弹性(Unna 靴和短拉伸绷带)治疗的成本效益,并计算增量成本效益比。

方法

通过 TreeAge®软件建模进行定量成本效益研究。预期假设是使用二次文献数据来估计假设参数的成本和效果。为此进行了系统的文献回顾和荟萃分析。

结果

回溯决策树显示,在基础情况下,多层治疗在所有选择中占据主导地位,尽管其每次应用的成本较高,但效果最佳。成本效益分析图还显示,Unna 靴在与短拉伸绷带的比较中具有更长的优势。敏感性分析表明,在支付意愿阈值内,多层绷带仍然是一种更具成本效益的选择。

结论

最具成本效益的选择是多层绷带,被认为是文献中的黄金标准。第二具成本效益的选择是 Unna 靴,是巴西最常用的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc21/10077846/6ef3955f3cae/1518-8345-rlae-31-e3839-en-f1.jpg

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